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Related Concept Videos

Pathophysiology of Cardiac Performance01:29

Pathophysiology of Cardiac Performance

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Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
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Heart Failure Drugs: Inotropic Agents01:26

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Specialized Characteristics of Cardiac Muscles01:27

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The primary role of cardiac muscles is to propel blood throughout the cardiovascular system. The cardiac muscle cells, or cardiomyocytes, exhibit specialized characteristics that allow them to perform this function.
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Evaluation of Cardiac Contractility Modulation Therapy in 2D Human Stem Cell-Derived Cardiomyocytes
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Evaluation of Cardiac Contractility Modulation Therapy in 2D Human Stem Cell-Derived Cardiomyocytes

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[Cardiac contractility modulation].

Karl-Heinz Kuck1,2, Amaar Ujeyl3, Julia Vogler4

  • 1Medizinische Klinik II, Universitätsklinikum Schleswig-Holstein - Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland. kuckkh@aol.com.

Herz
|November 19, 2021
PubMed
Summary
This summary is machine-generated.

Cardiac contractility modulation (CCM) offers a safe and effective treatment for heart failure (HF) patients not eligible for cardiac resynchronization therapy (CRT). CCM improves HF symptoms and reduces hospitalizations.

Keywords:
Cardiac resynchronizationDevice therapyHeart failureMyocardial contractionNarrow QRS complex

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Heart failure (HF) presents a growing global health challenge, impacting prognosis and quality of life despite medical advancements.
  • Cardiac resynchronization therapy (CRT) is standard for specific HF patients, but many remain unresponsive or ineligible.
  • Existing therapies have limitations, necessitating alternative treatment options for chronic HF management.

Purpose of the Study:

  • To review the mechanisms of action, clinical evidence, and current indications for cardiac contractility modulation (CCM).
  • To discuss recent advancements in CCM for treating patients with chronic heart failure.
  • To highlight CCM as a therapeutic option for HF patients unsuitable for CRT.

Main Methods:

  • Review of randomized clinical trials and scientific literature on cardiac contractility modulation (CCM).
  • Analysis of CCM's efficacy and safety in heart failure patients with specific ejection fraction and QRS duration criteria.
  • Examination of patient populations not benefiting from or ineligible for cardiac resynchronization therapy (CRT).

Main Results:

  • Cardiac contractility modulation (CCM) has demonstrated efficacy and safety in randomized trials.
  • CCM significantly reduces heart failure hospitalizations.
  • CCM improves heart failure symptoms, functional capacity, and patient quality of life.

Conclusions:

  • Cardiac contractility modulation (CCM) is a viable therapeutic option for heart failure patients with reduced ejection fraction and narrow QRS complexes who are not candidates for CRT.
  • CCM offers a significant benefit in reducing HF hospitalizations and improving patient-reported outcomes.
  • Further research and clinical application of CCM are warranted for optimizing chronic heart failure management.